Is your doctor 2square?

I wonder how many Malaysian doctors actively use email to communicate with patients? What about Twitter and Facebook?
This interesting article from AP questions if ur MD is 2square

CHICAGO (AP) – Is your doctor a technophobe? Increasingly, the answer may be no. There’s a stereotype that says doctors shun technology that might threaten patients’ privacy and their own pocketbooks. But a new breed of physicians is texting health messages to patients, tracking disease trends on Twitter, identifying medical problems on Facebook pages and communicating with patients through email.

So far, those numbers are small. Many doctors still cling to pen and paper, and are most comfortable using e-technology to communicate with each other – not with patients. But from the nation’s top public health agency, to medical clinics in the heartland, some physicians realize patients want more than a 15-minute office visit and callback at the end of the day.

Far from Silicon Valley and East Coast high-tech hubs, Kansas City pediatrician Natasha Burgert offers child-rearing tips on her blog, Facebook and Twitter pages, and answers patients’ questions by email and text messages.

“These tools are embedded in my work day,” Burgert said. “This is something I do in between checkups. It’s much easier for me to shoot you an email and show you a blog post than it is to phone you back. That’s what old-school physicians are going to be doing, spending an hour at the end of the day” returning patients’ phone calls, she said.

She recently received a typical email – from a mother wondering how to wean her 2-year-old from a pacifier. With a few thumb clicks, Burgert sent the mom a link to a blog post offering tips on that same topic.

Sarah Hartley, whose two young daughters are Burgert’s patients, loves having e-access to the doctor and says even emails late in the evening typically get a quick response.

“It’s so useful,” Hartley said. “Sometimes parents get concerned about a lot of things that maybe aren’t necessarily big deals” and getting off-hours reassurance is comforting, she said.

Burgert, 36, doesn’t charge for virtual communication, although some doctors do. She says it enhances but doesn’t replace office visits or other personal contact with patients.

Colleagues “look at me and kind of shake their heads when I tell them what I do. They don’t have an understanding of the tools,” Burgert said. “For the next generation that’s coming behind me, I think this will be much more common.”

Dr. Steven Nissen is from an older generation, but has started to dabble in e-technology. A cardiologist at the Cleveland Clinic, Nissen is in his 60s and says he’s hardly a member of “the Twitterati.” But with help from clinic staffers, he recently led a live Twitter chat about things like heart failure and cholesterol problems, and found the process “in some ways maybe a little exhilarating.”

“This was an opportunity to use a different communication channel to find an audience to talk about heart health,” Nissen said.

“The downside is that we dumb it down,” he said. “It’s very challenging for physicians, primarily because the messages that we have are not conducive to 14 characters. If you ask me a question, you’re likely to get a five-minute answer.”

But with so many young people facing obesity, which can contribute to heart problems, Nissen said Twitter can be an effective way to reach an important audience, and he plans to use it more.

“If it gets us through to the people who need to hear the message, that’s great,” Nissen said.

The American Medical Association acknowledges benefits in using social media, but also warns doctors to protect patient privacy and “maintain appropriate boundaries” with patients.

In a publicized case that makes doctors shudder, a state disciplinary board last year reprimanded Rhode Island emergency medicine physician Alexandra Thran for “unprofessional conduct” and fined her $500 after she made comments on her Facebook page about a patient’s injury. Even though she didn’t name the patient, others who read the post figured out the identity. Thran did not respond to requests for comment.

Dr. Raoul Wolf, a pediatrics professor at the University of Chicago, doesn’t use social media sites personally or professionally and worries about the permanence of online communication.

“With anything on the Internet, it’s there forever. There’s no calling it back,” Wolf said. “Ask any politician.”

I personally think using email to convey information like test results which otherwise would be pending until the next office visit, adds a personal touch. However doctors should be mindful of what they post in blogs and social media like Facebook and Twitter. There certainly should not be any breach of patient confidentiality. Patients too should be mindful that these modes of communication will not be an adequate replacement for an office visit and don’t go asking questions like “Is this serious?” via email when your doctor cannot assess you adequately in the virtual context.
In Malaysia we should also be careful of how we use new media given the controversial recent amendments to the Evidence Act

While I think email is quick, and allows me to answer at my convenience during my downtimes, this sometimes gets intrusive though. I have had patients email me whilst I was on vacation, asking questions or needing refills of their insulin or thyroid meds. Would have been better served contacting the clinic for my nurse to take care of.
Also, the article mentions how some doctors charge for virtual communication- i’m not even sure that’s allowable (at least in the USA) yet. Unless these are concierge doctors and private paying patients. This may end up burning out the doctor- there are weeks when I spend hours reviewing virtual/uploaded glucose/dosing data via patients’ insulin pumps (something we can do via the web)- these are hours spent outside of my usual work times, with no reimbursement whatsoever. There are times when this gets overwhelming